【摘要】 目的分析难治性肺炎支原体肺炎(RMPP)患儿维生素A(VitA)、白细胞介素(IL)-6、干扰素(IFN)-γ、IL-10水平。方法选择2018年2月至2019年3月于该院就诊的136例肺炎支原体(MP)感染患儿(疾病组)作为研究对象,根据相关诊断标准将其分为普通肺炎支原体肺炎(普通MPP)组(69例)和RMPP组(67例)。选取同期于该院体检的健康儿童72例作为对照组。收集患儿的临床资料,包括性别、年龄、热程以及肺部啰音、胸腔积液、肺外并发症和坏死性肺炎发生情况。测定并比较疾病组与对照组、普通MPP组与RMPP组血清VitA、IL-10、IFN-γ、IL-6水平。分析不同水平VitA与RMPP患儿临床特征的关系。探讨MPP患儿临床维生素A缺乏(CVAD)与IL-6、IFN-γ、IL-10的相关性。结果疾病组血清VitA、IL-6、IL-10、IFN-γ水平与对照组比较,差异均有统计学意义(P<0.05)。RMPP组血清VitA水平明显低于普通MPP组,差异有统计学意义(P<0.05);RMPP组血清IL-6、IL-10、IFN-γ水平明显高于普通MPP组(P<0.05)。VitA水平与性别、年龄和热程无关(P>0.05);低VitA水平与RMPP患儿的肺部啰音、胸腔积液、肺外并发症和坏死性肺炎有关(P<0.05)。MPP患儿CVAD与IL-6、IL-10和IFN-γ呈正相关(r=0.381、0.413、0.393,P <0.05)。结论临床应提高早期识别RMPP的能力,患儿若存在CVAD,血清IL-6、IL-10、IFN-γ水平明显升高,提示存在发生RMPP的可能。更多还原

【Abstract】 Objective To analysis vitamin A(VitA),interleukin(IL)-6,interferon(IFN)-γand IL-10 levels in children with refractory Mycoplasma pneumoniae pneumonia(RMPP).Methods One hundred and thirty-six children patients with MP in Xi′an Municipal Children′s Hospital from February 2018 to March 2019 were selected as the study subjects and divided into the common MPP group(n=69)and RMPP group(n=67)according to the related diagnosis standard.The contemporaneous 72 children undergoing physical examination in the hospital were selected as the control group.The general clinical data were collected,including the gender,age,fever course,lung rales,pleural effusion,extrapulmonary complications,and pulmonary necrotic inflammation.The levels of serum VitA,IL-10,IFN-γand IL-6 were detected and compared between the disease group and healthy control group,between the common MPP group and RMPP group.The effect of different levels of VitA on the clinical data of children patient with RMPP and the correlation between clinical VitA deficiency(CVAD)and IL-6,IFN-γ,IL-10 of MPP children patients were analyzed.Results The levels of serum VitA,IL-6,IL-10 and IFN-γhad statistical differences between the disease group and control group(P<0.05).The level of serum VitA in the RMPP group was significantly lower than that in the common MPP group,and the difference was statistically significant(P<0.05).The levels of serum IL-6,IL-10,and IFN-γin the RMPP group were significantly higher than those in the common MPP group(P<0.05).There was no correlation between VitA levels and gender,age and fever course(P>0.05);low VitA level in children patients with RMPP was closely correlated with the lung rales,pleural effusion,extrapulmonary complications,and pulmonary necrotic inflammation(P<0.05).Clinical VitA deficiency(CVAD)in children patients with MPP was positively correlated with the levels of IL-6,IL-10 and IFN-γ (r=0.381,0.413,0.393,P<0.05).Conclusion Clinic should elevate the ability for early identifying RMPP.If significant increase in CVAD,serum IL-6,IL-10 and IFN-γlevels exist,suggesting that RMPP may occur.更多还原